Surgical stapler with sloped staple deck for varying tissue compression

ABSTRACT

A cartridge for use with a surgical instrument includes a curved body and a deck defined by the curved body and configured to clamp tissue against an anvil. A plurality of staple openings is formed in the deck and is configured to house a plurality of staples. An arcuate slot is formed in the deck and is configured to slidably receive a cutting member therethrough. The deck includes a sloped deck portion that slopes away from the arcuate slot in a direction transverse to a length of the arcuate slot. The sloped deck portion is configured to provide varied compression of tissue across a width of the deck.

BACKGROUND

Some surgical staplers are operable to clamp down on one or more layersof patient tissue, form staples through the layers of tissue tosubstantially seal the layers of tissue together near the formedstaples, and cut through the layers of tissue for forming severed endsof operatively sealed tissue. An exemplary stapling instrument mayinclude a pair of cooperating elongate jaw members, where each jawmember may be adapted to be inserted into a patient and positionedrelative to tissue that is to be stapled and/or incised. One of the jawmembers may support a staple cartridge with at least two laterallyspaced rows of staples contained therein, and the other jaw member maysupport an anvil with staple-forming pockets aligned with the rows ofstaples in the staple cartridge. Generally, the stapling instrument mayfurther include a pusher bar and a knife blade that are slidablerelative to the jaw members to sequentially or simultaneously eject thestaples from the staple cartridge via camming surfaces on the pusher barand/or camming surfaces on a wedge sled that is pushed by the pusherbar. The camming surfaces may be configured to activate one or morestaple drivers carried by the cartridge and associated with the staplesin order to push the staples against the anvil and form laterally spacedrows of deformed staples in the tissue gripped between the jaw members.Such rows may be arranged as linear rows and/or arcuate rows forsequentially or simultaneously stapling and cutting the tissue of thepatient in the form of a predetermined pattern. The knife blade maytrail the camming surfaces and cut the tissue along a linear or arcuateline between the rows of staples formed in the tissue.

Merely exemplary surgical staplers are disclosed in U.S. Pat. No.6,988,650, entitled “Retaining Pin Lever Advancement Mechanism for aCurved Cutter Stapler,” issued Jan. 24, 2006; U.S. Pat. No. 7,134,587,entitled “Knife Retraction Arm for a Curved Cutter Stapler,” issued Nov.14, 2006; U.S. Pat. No. 7,147,139, entitled “Closure Plate Lockout for aCurved Cutter Stapler,” issued Dec. 12, 2006, U.S. Pat. No. 7,147,140,entitled “Cartridge Retainer for a Curved Cutter Stapler,” issued Dec.12, 2006; U.S. Pat. No. 7,204,404, entitled “Slotted Pins Guiding Knifein a Curved Cutter Stapler,” issued Apr. 17, 2007; and U.S. Pat. No.7,207,472, entitled “Cartridge with Locking Knife for a Curved CutterStapler,” issued Apr. 24, 2007. The disclosure of each of theabove-cited U.S. Patents is incorporated by reference herein. Additionalmerely exemplary surgical staplers are disclosed in U.S. Pat. Pub. No.2005/0139636, entitled “Replaceable Cartridge Module for a SurgicalStapling and Cutting Instrument,” published on Jun. 30, 2005, nowabandoned; U.S. Pat. Pub. No. 2005/0143759, entitled “Curved CutterStapler Shaped for Male Pelvis,” published on Jun. 30, 2005, nowabandoned; and U.S. Pat. Pub. No. 2005/0145672, entitled “Curved CutterStapler with Aligned Tissue Retention Feature,” published on Jul. 7,2005, now abandoned. The disclosure of each of the above-cited U.S.Patent Publications is incorporated by reference herein.

A surgical stapler may be inserted into a patient to perform colorectalsurgery. Such procedures may include the use of the stapler tooperatively seal, sever, and remove the colon of the patient, in wholeor in part. For instance, a proctocolectomy may be performed during alower anterior resection (“LAR”) for treating and inhibiting the spreadof colorectal cancer cells. Of course, surgical staplers may be used invarious other settings and procedures.

While various kinds of surgical stapling instruments and associatedcomponents have been made and used, it is believed that no one prior tothe inventor(s) has made or used the invention described in the appendedclaims.

BRIEF DESCRIPTION OF THE DRAWINGS

The accompanying drawings, which are incorporated in and constitute apart of this specification, illustrate embodiments of the invention,and, together with the general description of the invention given above,and the detailed description of the embodiments given below, serve toexplain the principles of the present invention.

FIG. 1A depicts a right front perspective view of an exemplary surgicalstapling instrument with a pin actuation mechanism in an open positionand a staple cartridge in open position;

FIG. 1B depicts a right front perspective view of the surgical staplinginstrument of FIG. 1A with the pin actuation mechanism in a closedposition and the staple cartridge in the open position;

FIG. 1C depicts a right front perspective view of the surgical staplinginstrument of FIG. 1A with the pin actuation mechanism in the closedposition and the staple cartridge in a closed position via actuation ofa closure mechanism;

FIG. 1D depicts a right front perspective view of the surgical staplinginstrument of FIG. 1A with the pin actuation mechanism and the staplecartridge in the closed positions and a firing trigger in a firedposition for stapling and cutting tissue of a patient;

FIG. 2 depicts a partially exploded front perspective view of thesurgical stapling instrument of FIG. 1A, showing the staple cartridgeremoved from a remainder of an end effector;

FIG. 3 depicts a front perspective view of the staple cartridge of FIG.2 ;

FIG. 4 depicts a rear perspective view of the staple cartridge of FIG. 2;

FIG. 5 depicts an exploded rear perspective view of the staple cartridgeof FIG. 2 ;

FIG. 6 depicts a front perspective view of another exemplary cartridgehousing configured for use with the surgical stapling unit of FIG. 1A;

FIG. 7 depicts an enlarged perspective view of a medial portion of adeck of the cartridge housing of FIG. 6 , showing details of tissueengagement features formed on the medial portion of the deck;

FIG. 8 depicts an enlarged perspective view of a first end portion ofthe deck of the cartridge housing of FIG. 6 , showing details of tissueengagement features formed on the first end portion of the deck;

FIG. 9 depicts an enlarged perspective view of an opposed second endportion of the deck of the cartridge housing of FIG. 6 , showing detailsof tissue engagement features formed on the second end portion of thedeck; and

FIG. 10 depicts a cross-sectional view of the cartridge housing of FIG.6 , showing a sloped configuration of the deck.

The drawings are not intended to be limiting in any way, and it iscontemplated that various embodiments of the invention may be carriedout in a variety of other ways, including those not necessarily depictedin the drawings. The accompanying drawings incorporated in and forming apart of the specification illustrate several aspects of the presentinvention, and together with the description serve to explain theprinciples of the invention; it being understood, however, that thisinvention is not limited to the precise arrangements shown.

DETAILED DESCRIPTION

The following description of certain examples of the invention shouldnot be used to limit the scope of the present invention. Other examples,features, aspects, embodiments, and advantages of the invention willbecome apparent to those skilled in the art from the followingdescription, which is by way of illustration, one of the best modescontemplated for carrying out the invention. As will be realized, theinvention is capable of other different and obvious aspects, all withoutdeparting from the invention. Accordingly, the drawings and descriptionsshould be regarded as illustrative in nature and not restrictive.

It is further understood that any one or more of the teachings,expressions, embodiments, examples, etc. described herein may becombined with any one or more of the other teachings, expressions,embodiments, examples, etc. that are described herein. Thefollowing-described teachings, expressions, embodiments, examples, etc.should therefore not be viewed in isolation relative to each other.Various suitable ways in which the teachings herein may be combined willbe readily apparent to those of ordinary skill in the art in view of theteachings herein. Such modifications and variations are intended to beincluded within the scope of the claims.

For clarity of disclosure, the terms “proximal” and “distal” are definedherein relative to a human or robotic operator of the surgicalinstrument. The term “proximal” refers the position of an element closerto the human or robotic operator of the surgical instrument and furtheraway from the surgical end effector of the surgical instrument. The term“distal” refers to the position of an element closer to the surgical endeffector of the surgical instrument and further away from the human orrobotic operator of the surgical instrument. It will be furtherappreciated that for convenience and clarity, spatial terms such as“vertical,” “horizontal,” “lower,” “upper,” “front,” and “rear” are usedherein with respect to the drawings. However, surgical instruments areused in many orientations and positions, and these terms are notintended to be limiting and/or absolute.

As used herein, the terms “about,” “approximately,” and the like inconnection with any numerical values or ranges of values are intended toencompass the exact value(s) referenced, as well as a suitabledimensional tolerance that enables the referenced feature or combinationof features to function for the intended purpose described herein.

I. Exemplary Surgical Stapler

FIGS. 1A-1D depict an exemplary surgical stapler (10) that includes ahandle assembly (12), a shaft assembly (14) extending distally fromhandle assembly (12), and an end effector (16) at a distal end of shaftassembly (14). It should be understood that terms such as “proximal,”“distal,” “right,” and “left” are used herein with reference to aclinician gripping handle assembly (12) of surgical stapler (10). Thus,end effector (16) is distal with respect to the relatively proximalhandle assembly (12). Except as otherwise described herein, surgicalstapler (10) may be configured and operable in accordance with at leastsome of the teachings of U.S. Pat. Pub. No. 2005/0143759, entitled“Curved Cutter Stapler Shaped for Male Pelvis,” published on Jun. 30,2005, now abandoned, the disclosure of which is incorporated byreference herein; and/or U.S. Pat. Pub. No. 2017/0027571 entitled“Surgical Instrument Comprising Systems for Assuring the ProperSequential Operation of the Surgical Instrument,” published on Feb. 2,2017, issued as U.S. Pat. No. 10,194,913 on Feb. 5, 2019, the disclosureof which is incorporated by reference herein.

Handle assembly (12) includes several actuation mechanisms for operatingend effector (16) during the surgical procedure. To this end, exemplaryhandle assembly (12) includes a saddle shaped slide (18), a closuretrigger (20), and a firing trigger (22) in communication with endeffector (16) via shaft assembly (14). FIG. 1A shows slide (18) andclosure trigger (20) in open configurations such that end effector (16)is configured to receive tissue laterally within a gap (25) of areplaceable cartridge unit (24) mounted within end effector (16),between an anvil (26) and a cartridge housing (28) of cartridge unit(24). As described in greater detail below, translating slide (18)distally toward end effector (16) slides a retaining pin (30) of endeffector (16) distally, as shown in FIG. 1B, for capturing the tissuebetween anvil (26) and cartridge housing (28). As shown in FIGS. 1C and1D, sequentially actuating closure trigger (20) and firing trigger (22)respectively compresses the tissue between anvil (26) and cartridgehousing (28) in a closed configuration, and then forms a plurality ofstaples (not shown) within the tissue and severs the tissue with acurved knife (32) (see FIG. 6 ).

A. Handle Assembly and Shaft Assembly of Surgical Stapler

As shown in FIG. 1A, handle assembly (12) of surgical stapler (10)includes a handle housing (34) and a pair of handle frame plates (35,36) having proximal portions (not shown) housed within handle housing(34) and elongate distal portions that extend distally along shaftassembly (14). As briefly described above, handle assembly (12) furtherincludes saddle shaped slide (18), closure trigger (20), and firingtrigger (22). Handle housing (34) defines a hand grip (38), which theoperator may grasp with the palm of at least one hand. Handle housing(34) of the present example is formed by a right shroud handle portion(40) and a left shroud handle portion (42). Closure trigger (20) isproximally positioned relative to firing trigger (22), and each trigger(20, 22) is pivotally mounted to frame plates (35, 36) and are exposedthrough an underside of handle housing (34) to be manipulated by thefingers of the operator. FIG. 1A shows closure and firing triggers (20,22) in unactuated positions prior to the closing of end effector (16)and firing of staples (not shown) and curved knife (32). Accordingly,cartridge housing (28) is spaced from anvil (26) for receiving tissuewithin gap (25) therebetween.

Surgical stapler (10) is operable to capture tissue via a tissueretaining pin actuation mechanism (37) prior to actuation of the closureand firing triggers (20, 22). Tissue retaining pin actuation mechanism(37) includes slide (18) of handle assembly (12), a tissue retaining pin(30) of end effector (16), and an elongate pushrod (50) of shaftassembly (14). Slide (18) is mounted on an upper surface of handlehousing (34) and is configured to linearly translate between proximaland distal positions. Pushrod (50) operatively couples slide (18) withtissue retaining pin (30), such that longitudinal translation of slide(18) drives longitudinal actuation of tissue retaining pin (30) betweena proximal open position (see FIG. 1A) and a distal closed position (seeFIG. 1B), via pushrod (50).

A closure mechanism (52) of surgical stapler (10) is configured toselectively actuate cartridge housing (28) of cartridge unit (24)between a proximal open position (FIG. 1A) and a distal closed position(FIG. 1C) for clamping tissue between cartridge housing (28) and anvil(26). Closure mechanism (52) includes closure trigger (20) of handleassembly (12) and an elongate closure member (54) coupled at itsproximal end with closure trigger (20). Closure member (54) has agenerally U-shaped cross-section and extends distally from handleassembly (12), through shaft assembly (14), and into end effector (16),such that a distal end of closure member (54) is configured to receivecartridge unit (24) within end effector (16), as shown in FIG. 2 . Aproximal end of closure member (54) is operatively connected withclosure trigger (20) by a plurality of linkages (not shown) configuredto convert pivoting motion of closure trigger (20) into translation ofclosure member (54). Accordingly, pivoting of closure trigger (20)toward pistol grip (38) to a closed position (FIG. 1C) drives closuremember (54) distally, which in turn drives cartridge housing (28)distally toward anvil (26) for clamping tissue therebetween.Subsequently, pivoting of closure trigger (20) away from pistol grip(38) to an open position (FIG. 1A) drives closure member (54)proximally, which in turn drives cartridge housing (28) proximally awayfrom anvil (26) for releasing stapled tissue.

In some versions, closure member (54) may be further configured tocooperate with tissue retaining pin actuation mechanism (37) toautomatically actuate retaining pin (30) distally to its closed positionwhen the operator squeezes closure trigger (20). Such automation may beuseful in the event that the operator did not manually actuate retainingpin (30) distally via slide (18) prior to squeezing closure trigger(20). Closure trigger (20) may be biased toward the open position by aresilient member (not shown) housed within handle housing (34).

A firing mechanism (80) of surgical stapler (10) is configured toactuate end effector (16) to staple and sever tissue clamped betweenanvil (26) and cartridge housing (28) in response to manipulation offiring trigger (22) of handle assembly (12). In that regard, firingmechanism (80) includes firing trigger (22), cartridge unit (24), and anelongate firing bar (not shown) that extends longitudinally throughshaft assembly (14) and operatively couples firing trigger (22) withcartridge unit (24). Firing trigger (22) is positioned distally ofclosure trigger (20) such that firing trigger (22) may be pivoted closedonly once closure trigger (20) has first been pivoted closed. Pivotingof firing trigger (22) from an open position (FIG. 1C) toward a closed(or “fired”) position (FIG. 1D) drives the firing bar distally, which inturn drives internal components of cartridge housing (28) distally tothereby staple and sever the tissue clamped by end effector (16), asdescribed in greater detail below.

One or both of closure trigger (20) and firing trigger (22) may beconfigured to releasably lock in one or more pivot positions, such as afully closed position and/or one or more intermediate positions betweenfully open (i.e., unactuated) and fully closed (i.e., fully actuated),for example. Accordingly, and advantageously, the operator may releaseone or more hands from the trigger (20, 22) and hand grip (38) toperform another task during the surgical procedure, while the trigger(20, 22) maintains its position. The operator may then release thetrigger (20, 22) from its locked state by depressing a release button(23) arranged on a proximal end of handle assembly (12).

Though not shown, shaft assembly (14) of surgical stapler (10) mayinclude various additional components, such as an articulating joint, ormay include a rearrangement of various components such that shaftassembly (14) may be modular relative to handle assembly (12).

B. End Effector of Surgical Stapler

As shown best in FIGS. 3-5 , end effector (16) of the present exampleincludes a C-shaped support structure (128) and replaceable cartridgeunit (24) removably received by C-shaped support structure (128).Support structure (128) of the present example is secured to the distalends of handle frame plates (35, 36) at the distal end of shaft assembly(14) by a shoulder rivet (129) and a pair of posts (130). The term“C-shaped” is used herein as reference to the curvature of supportstructure (128) and cartridge unit (24), each of which has a concavefirst lateral side and a convex second lateral side opposed from oneanother. Such a configuration provides enhanced functionality and accessto tissue within the patient. By way of example only, the C-shapedconstruction of support structure (128) and cartridge unit (24) mayenable end effector (16) to easily access the lower colon within thepelvic bowl of a patient, for example for performing a lower anteriorresection (“LAR”) in a proctocolectomy procedure. According, the term“C-shaped” as used herein should be construed to include a variety ofconcave shapes that would similarly enhance the functionality ofsurgical stapling and cutting instruments.

Replaceable cartridge unit (24) includes anvil (26) and cartridgehousing (28), movably coupled to one another by a guide pin (166) and ananvil arm (196), as described in greater detail below. A distal end ofcartridge housing (28) defines a distally facing staple deck (134)configured to contact tissue. Staple deck (134) includes a plurality ofstaple openings (136) arranged in staggered formation in a pair of rowson each side of an arcuate knife slot (152). Various other quantities ofrows of staple openings (136) may be provided in other versions.Cartridge housing (28) houses a plurality of staples (not shown)configured to be driven distally through staple openings (136) andagainst anvil (26) to thereby form the staples in patient tissues.Though not shown, cartridge unit (134) may further include a retainerconfigured to removable couple to staple deck (134) to cover stapleopenings (136) and knife slot (152) before use of cartridge unit (24),for instance when cartridge unit (24) is stored, and optionally alsoafter use of cartridge unit (24).

As shown in FIG. 6 , cartridge housing (28) additionally housesretaining pin (30), a staple driver assembly (140), and a knife holder(142). Staple driver assembly (140) is positioned just proximally of thestaples (not shown) housed within cartridge housing (28) and distally ofknife holder (142). Staple driver assembly (140) of the present exampleis formed as a unitary structure defining a plurality of staple drivers(141). Thus, the term “assembly,” as used in connection with stapledriver assembly (140), is not intended to be limited to an assembly ofindividual components, but may also include integrally formed componentswith unitary structures. Driver assembly (140) is configured totranslate distally within cartridge housing (28) so that staple drivers(141) drive staples distally from respective staple openings (136) andtoward anvil (26) for formation within tissue clamped between anvil (26)and cartridge housing (28).

Knife holder (142) is movably disposed within cartridge housing (8) justproximally of staple driver assembly (140). Knife holder (142) supportscurved knife (32) along a distal side thereof, and knife holder (142) isconfigured to translate within cartridge housing (28) such that curvedknife (32) extends distally through an arcuate slot (150) of driverassembly (140) and arcuate slot (152) of staple deck (134), A proximalside of knife holder (142) includes a slot (144) and a ledge (146)configured to couple with a knife retractor hook (not shown) forretraction of curved knife (32) after firing of cartridge unit (24), forexample as disclosed in U.S. Pat. No. 10,045,780, entitled “Method ofApplying Staples in Lower Anterior Bowel Resection,” issued Aug. 14,2018, the disclosure of which is incorporated by reference herein.

As shown in FIG. 4 , a lateral side of cartridge housing (28) includes alongitudinally extending detent slot (155) defined between a confrontingpair of resilient members. A first side of detent slot (155) includes afirst proximal detent protrusion (156), and an opposed second side ofdetent slot (155) includes a second proximal detent protrusion (159) anda distal detent protrusion (160). Detent slot (155) is configured toslidably receive a detent post (154) of knife holder (142) and a detentpost (158) of staple driver assembly (140). As staple driver assembly(140) and knife holder (142) translate distally within cartridge housing(28), detent post (154) resiliently engages detent protrusion (156), anddetent post (158) resiliently engages detent protrusions (159, 160).

As shown in FIG. 3 , cartridge housing (28) includes two longitudinallyextending, generally circular holes (162, 164) at respective upper andlower ends of arcuate knife slot (152) on staple deck (134). Holes (162,164) of the present example are positioned such that staple openings(136), and the staples ejected therefrom, extend beyond holes (162, 164)at the upper and lower ends of staple deck (134). Lower hole (162) isshaped and dimensioned to slidably receive a guide pin (166) thatextends longitudinally, between cartridge housing (28) and anvil (26).Upper hole (164) is shaped and dimensioned to slidably receive retainingpin (30) therethrough, such that retaining pin (30) may actuatelongitudinally relative to cartridge housing (2.8) and anvil (26)between the proximal retracted position (FIG. 1A) and the distalextended position (FIG. 1B).

As shown in FIG. 5 , a proximal end of retaining pin (30) includes afirst coupling feature (172) (e.g., a projection) configured to couplewith a corresponding coupling feature (not shown) (e.g., a groove) of acouplet (170), so that retaining pin (30) is secured to couplet (170).Couplet (170) and retaining pin (30) are slidably disposed within anupper arm (176) of cartridge housing (28), and are captured proximallytherein by an end cap (178) secured to upper arm (176) proximally ofcouplet (170). A distal end of pushrod (50) of tissue retaining pinactuation mechanism (37), described above, is operatively coupled withcouplet (170). Accordingly, longitudinal actuation of pushrod (50) viaslide (18) of handle assembly (12) drives couplet (170) and thusretaining pin (30) longitudinally relative to cartridge housing (28) forcapturing tissue to be stapled by end effector (16).

Anvil (26) of the present example includes a plastic cutting washer(168) and a metallic staple-forming surface (138) secured to a proximalside of cutting washer (168). Staple-forming surface (138) includes anelongate arcuate slot (192) configured to receive an arcuate projection(169) of cutting washer (168) therethrough to secure staple-formingsurface (138) relative to cutting washer (168). Staple-forming surface(138) further includes a plurality of pockets arranged in rows alongeither side of arcuate slot (192). These pockets are configured toreceive and form the legs of staples driven distally from stapleopenings (136) of staple deck (134). Accordingly, anvil (26) is spaceddistally from and is aligned with staple deck (134) such that eachpocket of staple-forming surface (138) aligns with a respective stapleopening (136).

Staple-forming surface (138) of anvil (26) further includes a firstcircular opening (194) disposed at an upper end of arcuate slot (192),and a second circular opening (see FIG. 4 ) disposed at a lower end ofarcuate slot (192). First opening (194) is configured to slidablyreceive a pointed distal tip of tissue retaining pin (30) when tissueretaining pin (30) is actuated distally to capture tissue positionedbetween anvil (26) and cartridge housing (28). The lower second openingof staple-forming surface (138) receives a distal end (190) of guide pin(166) therethrough, which extends into and fixedly couples to a lowerend of cutting washer (168), such that guide pin (166) is longitudinallyfixed relative to anvil (26).

A proximal end (188) of guide pin (166) is slidably received throughlower hole (162) formed in staple deck (134) of cartridge housing (28),as described above. An anvil arm (196) projecting proximally from alower end of staple-forming surface (138) is movably received through anopen lower end of cartridge housing (28) to thereby trap proximal end(188) of guide pin (166) within cartridge housing (28), while stillpermitting cartridge housing (28) to actuate toward anvil (26).Accordingly, cartridge housing (28) is configured to slidelongitudinally along guide pin (166) (and tissue retaining pin (30))relative to anvil (26) in response to actuation of closure trigger (20),described above. As shown in FIG. 4 , an interior side of guide pin(166) includes a longitudinal slot (180) configured to slidably receivea corresponding lower end (184) of curved knife (32) as cartridgehousing (28) actuates longitudinally relative to anvil (26). An interiorside of tissue retaining pin (30) may include a similar longitudinalslot (not shown) configured to slidably receive a corresponding upperend (186) of curved knife (32) as cartridge housing (28) actuateslongitudinally relative to anvil (26).

C. Exemplary Actuation of Surgical Stapler

Having described various structural features of surgical stapler (10)above, including cartridge unit (24), exemplary actuation of surgicalstapler (10) during a surgical procedure will now be described below.Surgical stapler (10) is first suitably manipulated within a body cavityof a patient to position patient tissue within gap (25) (see FIG. 1A)between anvil (26) and cartridge housing (28). As shown in FIG. 1B,slide (18) is then actuated distally to drive pushrod (50) distally,thereby driving tissue retaining pin (30) distally from cartridgehousing (28) toward anvil (26). The pointed distal tip of tissueretaining pin (30) securely engages (e.g., pierces) the tissue andthereby captures the tissue within gap (25).

As shown in FIG. 1C, closure trigger (20) is then squeezed toward pistolgrip (38) to drive closure member (54) distally, thereby drivingcartridge housing (28) distally toward anvil (26) along tissue retainingpin (30) and guide pin (166) to clamp the tissue between cartridge deck(134) and anvil (26). Cartridge housing (28) may be maintained in thisclosed position relative to anvil (26) by an internal locking mechanism(not shown) of handle assembly (12) that holds closure trigger (20) inthe squeezed position, as described above. As shown in FIG. 1D, whilecartridge unit (24) remains in this closed position, firing trigger (22)is then squeezed toward closure trigger (20) and pistol grip (38) todrive the elongate firing bar (not shown) distally, thereby drivingstaple driver assembly (140) and knife holder (142) distally withincartridge housing (28). Stapler drivers (141) of driver assembly (140)drive staples (not shown) distally through the captured tissue andagainst staple-forming surface (138) of anvil (26) to form the stapleswithin the tissue and thereby fluidly seal the tissue. As the staplesare being formed, curved knife (32) is driven distally by knife holder(142) through arcuate slots (150, 152) and into the clamped tissue tothereby sever the tissue along an arcuate path extending between the twoinnermost rows of the formed staples. Similar to closure trigger (20),firing trigger (22) may be held in its squeezed position by the internallocking mechanism (not shown) of handle assembly (12). It will beappreciated that surgical stapler (10) may be configured in someversions such that the tissue clamped by end effector (16) within gap(25) is stapled and cut simultaneously; and be alternatively configuredin other versions such that the tissue is fully stapled and subsequentlycut in sequential steps.

Once surgical stapler (10) has been fully fired into the patient tissueas described above, the operator may depress release button (23) ofhandle assembly (12) to release firing trigger (22) and closure trigger(20) from their squeezed positions. In this manner, curved knife (32)may be retracted proximally back into cartridge housing (28), andcartridge housing (28) may be retracted proximally along pins (20, 166)to thereby release the newly stapled and severed tissue from betweenanvil (26) and cartridge deck (134). The fired cartridge unit (24) maythen be removed from support structure (128) of end effector (16),discarded, and replaced for further treatment if so desired.

Surgical stapler (10) may be further configured and operable inaccordance with any of the teachings of the references cited herein,including U.S. Pat. No. 10,045,780, incorporated by reference above.

II. Exemplary Cartridge Housing Having Sloped Deck

In some instances, it may be desirable to provide a version of cartridgehousing (28) that includes features that enhance gripping andstabilization of tissue during actuation of cartridge unit (24). Such aconfiguration may promote successful cutting and stapling of the tissue,and mitigate any damage caused to the tissue during such treatment. FIG.6 shows an exemplary alternative cartridge housing (200) configured insuch a manner, and which may be readily incorporated into cartridge unit(24) described above in place of cartridge housing (28). Cartridgehousing (200) is configured and operable in a manner similar tocartridge housing (28), except as otherwise described below.

Cartridge housing (200) includes a curved body (202) that extends alongan arcuate path and has an open lower body end (204), a closed upperbody end (206), and an upper arm (208) extending proximally from upperbody end (206). Curved body (202) and upper arm (208) of the presentexample have hollow interiors that communicate with one another and areconfigured to house respective moveable components similar to cartridgehousing (28) described above. In particular, curved body (202) isconfigured to movably house staple driver assembly (140), a plurality ofstaples (not shown), knife holder (142), and curved knife (32), shown inFIG. 5 . Upper arm (208) is configured to movably house tissue retainingpin (30) and couplet (170), which are retained within upper arm (208) byend cap (178), also shown in FIG. 5 . Cartridge housing (200) isconfigured to couple with anvil (26) in a manner similar to cartridgehousing (28) described above to define a cartridge unit similar tocartridge unit (24). The resulting cartridge unit is configured to beremovably received by C-shaped support structure (128) of end effector(16) such that curved body (202) couples with the distal ends of frameplates (35, 36) of closure mechanism (52); such that couplet (170)couples with the distal end of pushrod (50) of tissue retaining pinactuation mechanism (37); and such that staple driver assembly (140) andknife holder (142) couple with the distal end of the firing bar (notshown) of firing mechanism (80).

A distal face of curved body (202) of cartridge housing (200) defines adistally-facing staple deck (210) that extends along the arcuate path ofcurved body (202) and has a first elongate side edge (212) that extendsalong a convex side of curved body (202), and an opposed second elongateside edge (214) that extends along a concave side of curved body (202).As described in greater detail below in connection with FIG. 10 , stapledeck (210) of the present example is sloped away from arcuate knife slot(218) in a downward direction toward deck side edges (212, 214). Similarto staple deck (134) described above, staple deck (210) is configured toclamp tissue against staple-forming surface (138) of anvil (26) whencartridge housing (200) is actuated distally toward anvil (26). Stapledeck (210) includes a plurality of staple openings (216) configured tohouse a plurality of staples (not shown) that are driven distallythrough staple openings (216) by staple drivers (141) of staple driverassembly (140) for stapling clamped tissue in response to actuation offiring mechanism (80).

As shown best in FIG. 7 , staple deck (210) further includes an arcuateknife slot (218) extending along an arcuate centerline of deck (210) soas to divide deck (210) into first and second elongate side portions.Arcuate knife slot (218) is configured to slidably receive curved knife(32) distally therethrough for cutting clamped tissue in response toactuation of firing mechanism (80). Staple openings (216) are arrangedin a plurality of rows extending along arcuate paths parallel to arcuateknife slot (218) on the first and second side portions of deck (210). Inthe present version, each side portion of deck (210) includes an innerrow and an outer row of staple openings (216), such that two rows ofstaple openings are arranged on each side of arcuate knife slot (218).Staple openings (216) of adjacent inner and outer rows are arranged in astaggered formation relative to one another. It will be appreciated thatstaple openings (216) may be arranged in various other row quantitiesand configurations in other versions.

As shown best in FIG. 8 , staple deck (210) further includes a firstcircular opening (220) arranged at a first end of arcuate knife slot(218) adjacent to upper body end (206). First circular opening (220) isaligned with and communicates directly with the first end of arcuateknife slot (218), and is configured to slidably receive tissue retainingpin (30) (see FIG. 5 ) therethrough. An end pair of staple openings(216) extends beyond first circular opening (220) in a direction towardupper body end (206). Accordingly, and advantageously, the staplesejected by the end pair of staple openings (216) are formed in tissuesuch that a hole formed in the tissue by tissue retaining pin (30)exhibits little to no leakage of fluid before a subsequent adjacent lineof staples is applied to the tissue. As shown best in FIG. 9 , stapledeck (210) further includes a second circular opening (222) arranged ata second end of arcuate knife slot (218) adjacent to lower body end(204). Second circular opening (222) is aligned with and communicatesdirectly with the second end of arcuate knife slot (218), and isconfigured to receive a proximal portion of guide pin (166) (see FIG. 5) therethrough.

As shown in FIG. 8 , staple deck (210) of the present example furtherincludes an annular wall (224) that substantially encircles firstcircular opening (220) and protrudes away from deck (210) to define araised annular surface (226) offset from deck (210). In the presentexample, annular wall (224) is integrally connected with an adjacentpair of cleats (240), described below, disposed on opposed lateral sidesof annular wall (224). Deck (210) further includes a pair of elongateridges (228) that extend along opposing sides of arcuate knife slot(218) and project away from deck (210) to define raised ridge surfaces(230). Raised ridge surfaces (230) interconnect flush with raisedannular surface (226) of annular wall (224) at the corresponding firstend of arcuate knife slot (218). Elongate ridges (228) terminate at theopposed second end of arcuate knife slot (218), as shown in FIG. 9 .Raised annular surface (226) is configured to clamp tissue against anvil(26) and thereby fix the tissue relative to first circular opening (220)to minimize tissue flow around tissue retaining pin (30) during cuttingand stapling of tissue, and during subsequent proximal retraction oftissue retaining pin (30) into cartridge housing (200). Similarly,raised ridge surfaces (230) are configured to clamp tissue against anvil(26) and thereby fix the tissue relative to arcuate knife slot (218) tominimize tissue flow around knife slot (218) during cutting and staplingof the tissue.

As shown in FIGS. 6 and 8 , a tissue gap post (232) is disposed onstaple deck (210) just beyond first circular opening (220) in adirection toward upper body end (206), and in alignment with firstcircular opening (220) and arcuate knife slot (218). Tissue gap post(232) projects away from deck (210) and is configured to abut a firstend of anvil (26) when cartridge housing (200) is driven distallyagainst anvil (26). In this manner, tissue gap post (232) defines aminimum tissue gap between staple deck (210) and staple-forming surface(138) of anvil (26).

As shown in FIGS. 6 and 9 , a tissue stop tab (234) is disposed onstaple deck (210) just beyond second circular opening (222) in adirection toward lower body end (204), and in alignment with secondcircular opening (222) and arcuate knife slot (218). Tissue stop tab(234) projects away from deck (210) and functions as a stop feature thatprevents tissue from flowing beyond lower body end (204) during cuttingand stapling of the tissue. In some versions, tissue stop tab (234) isfurther configured to abut a second end of anvil (26) when cartridgehousing (200) is driven distally, such that tissue stop tab (234)cooperates with tissue gap post (232) to define the minimum tissue gapbetween staple deck (210) and staple-forming surface (138) of anvil(26).

As shown in FIGS. 7-9 , staple deck (210) of cartridge housing (200)further includes a plurality of tissue engagement features in the formof stand-off members (240, 250, 252, 254) that project away from deck(210). Stand-off members (240, 250, 252, 254) are distributed along alength of deck (210) and are laterally offset from arcuate knife slot(218) to align with and open to a respective one or more staple openings(216). As described below, stand-off members (240, 250, 252, 254) areconfigured to grip and thereby stabilize tissue when deck (210) isclamped against anvil (26); and, moreover, optimize tissue compressionat the staple locations to facilitate effective stapling and cutting ofthe tissue.

As shown best in FIG. 7 , a first set of stand-off members on stapledeck (210) is shown in the form of cleats (240) arranged discretelyalong the length of arcuate knife slot (218) in alignment with stapleopenings (216). Each cleat (240) includes a first end feature (242) thatwraps partially around an end portion of a first staple opening (216)within a given row of staple openings (216), and an opposed second endfeature (244) that wraps partially around an end portion of an adjacentsecond staple opening (216) within the row of staple openings (216).First and second end features (242, 244) are integrally connected by arecessed bridge portion (246).

Each end feature (242, 244) of a cleat (240) is generally U-shaped anddefines an inner wall that joins with and protrudes outwardly from aninner wall of the respective staple opening (216). In this manner, eachend feature (242, 244) opens to and communicates with a respectivestaple opening (216). Accordingly, each end feature (242, 244) isconfigured to guide a respective staple leg of a corresponding staple(not shown) as the staple is ejected distally from the staple opening(216) by a staple driver (141). Each end feature (242, 244) thuscooperates with a confronting end feature (242, 244) of an adjacentcleat (240), or with an endcap (250, 252, 254) described below, toprovide such guidance of the staples. In the present version, thelateral side of each end feature (242, 244) that laterally confronts anend feature (242, 244) of an adjacent row of cleats (240) is formed witha reduced wall thickness relative to an opposed lateral side of the sameend feature (242, 244).

While cleats (240) of the present example are discretely formed relativeto one another such that each cleat (240) is freestanding and is spacedapart from adjacent cleats (240), in other examples cleats (240) may beinterconnected with one another along one or more portions of stapledeck (210).

As shown in FIGS. 8 and 9 , staple deck (210) includes additionalstand-off members in the form of outer row endcaps (250) disposed atboth ends of the outer rows of staple openings (216). In the presentversion, each outer row endcap (250) has a U-shape similar to endfeatures (242, 244) of cleats (240), and wraps partially around an endportion of a respective staple opening (216) at the end of a respectiveouter row of staple openings (216). Accordingly, each outer row endcap(250) cooperates with a confronting end feature (242, 244) of anadjacent cleat (240) within the same row to guide a respective staple(not shown) distally into tissue as the staple is being ejected. In thepresent example, an inner surface of each outer row end cap (250) isintegrally connected with an end feature (242, 244) of an adjacent cleat(240) of the adjacent inner row of cleats (240).

As shown in FIG. 8 , a pair of first end inner row endcaps (252) isdisposed at the ends of the inner rows of staple openings (216) at upperbody end (206). First end inner row endcaps (252) of the present exampleare disposed on opposed lateral sides of tissue gap post (232) and areintegrally joined with tissue gap post (232) (with only one endcap (252)being shown in FIG. 8 ). First end inner row endcaps (252) are otherwisesimilar to outer row endcaps (250) in that each endcap (252) has aU-shaped opening that wraps partially around an end portion of anend-most staple opening (216) and cooperates with a confronting endfeature (242, 244) of a cleat (240) within the same row to guide astaple during distal ejection.

As shown in FIG. 9 , a pair of second end inner row endcaps (254) isdisposed at the ends of the inner rows of staple openings (216) at lowerbody end (204). Second end inner row endcaps (254) of the presentexample are disposed on opposed lateral sides of tissue stop tab (234)and are integrally joined with tissue stop tab (234). Second end innerrow endcaps (254) are similar to outer row endcaps (250) in that eachendcap (254) has a U-shaped opening that wraps partially around an endportion of an end-most staple opening (216) and cooperates with aconfronting (242, 244) of a cleat (240) within the same row to guide astaple during distal ejection.

In the present example, cleats (240), outer row endcaps (250), and firstend inner row endcaps (252) each protrude from deck (210) with a similarfirst maximum height and thus collectively define an upper plane. Incontrast, second end inner row endcaps (254) each protrude from deck(210) with a second maximum height that is greater than the firstmaximum height, so as to extend above the above the upper plane ofmembers (240, 250, 252). Such configuration and corresponding advantagesare disclosed in greater detail in U.S. patent application Ser. No.16/234,727, entitled “Surgical Stapler with Tissue Engagement FeaturesAround Tissue Containment Pin,” filed on Dec. 21, 2021, issued as U.S.Pat. No. 11,202,268 on Dec. 21, 2021, the disclosure of which isincorporated by reference herein.

As shown in FIG. 10 , each side portion of staple deck (210) is slopedaway from arcuate knife slot (218) in a downward direction toward therespective side edge (212, 214) of deck (210). Accordingly, an outermostportion of each deck side portion disposed laterally outward of cleats(240) is recessed below a corresponding innermost portion of the deckside portion disposed laterally inward of cleats (240), along a fulllength of arcuate knife slot (218). Furthermore, each side portion ofdeck (210) is uniformly sloped away from arcuate knife slot (218) at thesame degree (θ) relative to the upper plane defined by the uppersurfaces of cleats (240), outer row endcaps (250), and first end innerrow endcaps (252). In alternative versions, the first and second sideportions of deck (210) may sloped downwardly away from arcuate knifeslot (218) by differing degrees (θ). Advantageously, the downwardlysloping configuration of the side portions of staple deck (210) providesvarying compression of tissue across the lateral width of deck (210). Inparticular, a higher degree of tissue compression is applied neararcuate knife slot (218), and a lesser degree of compression is appliednear deck side edges (212, 214). Accordingly, this sloped configurationof deck (210) cooperates with stand-off members (240, 250, 252, 254) tooptimize tissue compression at the tissue cut line and at the staplelocations to effectively stabilize the tissue during stapling andcutting, while minimizing tissue compression at deck side edges (212,214) to prevent over-compression of tissue, as described further below.

It should be understood that the protruding configuration of stand-offmembers (240, 250, 252, 254) relative to deck (210) provides multipleadvantages. In particular, when tissue is compressed between deck (210)and anvil (26) as described above, portions of the compressed tissuewill enter the recessed areas in and around stand-off members (240, 250,252, 254) (e.g., recessed bridge portions (246) and separation gaps). Asa result of some tissue entering these recessed areas, tissuecompression is optimized at the staple locations corresponding tostand-off members (240, 250, 252, 254) while the total pressure appliedto the compressed tissue is decreased relative to a theoreticalalternative configuration in which staple deck (210) is flat. Byreducing the total pressure applied to the compressed tissue, the riskof damaging the tissue through over-compression is reduced. In additionto reducing the total pressure applied to the compressed tissue, theentry of tissue portions into the recessed areas in and around stand-offmembers (240, 250, 252, 254) provides an enhanced gripping effect on thecompressed tissue that is enhanced relative to a theoretical alternativeconfiguration in which staple deck (210) is flat. The enhanced grippingof tissue may promote cleaner cutting by knife (32) and more effectivedeployment of staples into the tissue. Thus, the provision of stand-offmembers (240, 250, 252, 254) may both reduce the risk ofover-compression of tissue and promote greater success in cutting andstapling the tissue.

III. Exemplary Combinations

The following examples relate to various non-exhaustive ways in whichthe teachings herein may be combined or applied. It should be understoodthat the following examples are not intended to restrict the coverage ofany claims that may be presented at any time in this application or insubsequent filings of this application. No disclaimer is intended. Thefollowing examples are being provided for nothing more than merelyillustrative purposes. It is contemplated that the various teachingsherein may be arranged and applied in numerous other ways. It is alsocontemplated that some variations may omit certain features referred toin the below examples. Therefore, none of the aspects or featuresreferred to below should be deemed critical unless otherwise explicitlyindicated as such at a later date by the inventors or by a successor ininterest to the inventors. If any claims are presented in thisapplication or in subsequent filings related to this application thatinclude additional features beyond those referred to below, thoseadditional features shall not be presumed to have been added for anyreason relating to patentability.

Example 1

A cartridge for use with a surgical instrument, the cartridgecomprising: (a) a curved body; (b) a deck defined by the curved body,wherein the deck is configured to clamp tissue against an anvil; (c) aplurality of staple openings formed in the deck, wherein the stapleopenings are configured to house a plurality of staples; and (d) anarcuate slot formed in the deck, wherein the arcuate slot is configuredto slidably receive a cutting member therethrough, wherein the deckincludes a sloped deck portion that slopes away from the arcuate slot ina direction transverse to a length of the arcuate slot, wherein thesloped deck portion is configured to provide varied compression oftissue across a width of the deck.

Example 2

The cartridge of Example 1, wherein the sloped deck portion extendsalong a full length of the arcuate slot.

Example 3

The cartridge of any of the preceding Examples, wherein at least some ofthe staple openings are arranged on the sloped deck portion.

Example 4

The cartridge of any of the preceding Examples, wherein the deckincludes a first elongate side edge and an opposed second elongate sideedge, wherein the sloped deck portion comprises: (i) a first sideportion of the deck that slopes away from the arcuate slot in adirection toward the first elongate side edge, and (ii) a second sideportion of the deck that slopes away from the arcuate slot in adirection toward the second elongate side edge.

Example 5

The cartridge of any of the preceding Examples, further comprising aplurality of stand-off members arranged on the deck, wherein thestand-off members are configured to engage tissue.

Example 6

The cartridge of Example 5, wherein at least some of stand-off membersare arranged on the sloped deck portion.

Example 7

The cartridge of any Examples 5 through 6, wherein top surfaces of thestand-off members collectively define an upper plane, wherein the slopeddeck portion is sloped relative to the upper plane.

Example 8

The cartridge of any of Examples 5 through 7, wherein the stand-offmembers are laterally offset from the arcuate slot.

Example 9

The cartridge of any of the preceding Examples, wherein each of thestand-off members wraps around at least a portion of an adjacent stapleopening.

Example 10

The cartridge of any of the preceding Examples, wherein at least some ofthe stand-off members include a first end feature that wraps at leastpartially around an end portion of a first staple opening, and anopposed second end feature that wraps at least partially around an endportion of a second staple opening.

Example 11

The cartridge of Example 10, wherein the first end feature is connectedwith the second end feature by a recessed bridge portion.

Example 12

The cartridge of any of the preceding Examples, further comprising apair of ridges extending along opposed sides of the arcuate slot.

Example 13

The cartridge of any of the preceding Examples, further comprising acircular opening formed in the deck adjacent to an end of the arcuateslot, wherein the circular opening is configured to slidably receive apin therethrough.

Example 14

The cartridge of Example 13, wherein the circular opening communicateswith the arcuate slot.

Example 15

The cartridge of any of Examples 13 through 14, wherein at least one ofthe staple openings extends beyond the circular opening in a directiontoward a corresponding end of the deck.

Example 16

A cartridge for use with a surgical instrument, the cartridgecomprising: (a) a curved body; (b) a deck defined by the curved body,wherein the deck is configured to clamp tissue against an anvil, whereinthe deck includes a first elongate side edge and an opposed secondelongate side edge; (c) an arcuate slot formed in the deck, wherein thearcuate slot extends along the deck and between the first and secondelongate side edges, wherein the arcuate slot is configured to slidablyreceive a cutting member therethrough; and (d) a plurality of stapleopenings formed in the deck, wherein the staple openings are configuredto house a plurality of staples, wherein a first row of the stapleopenings extends along the deck between the first elongate side edge andthe arcuate slot, wherein a second row of the staple openings extendsalong the deck between the second elongate side edge and the arcuateslot, wherein a first outer portion of the deck extending between thefirst elongate side edge and the first row is recessed relative to atissue contacting portion of the arcuate slot, wherein a second outerportion of the deck extending between the second elongate side edge andthe second row is recessed relative to the tissue contacting portion ofthe arcuate slot.

Example 17

The cartridge of Example 16, wherein the deck comprises a first innerportion extending between the arcuate slot and the first row, and asecond inner portion extending between the arcuate slot and the secondrow, wherein the first inner portion and the first outer portion slopeaway from the arcuate slot in a first direction, wherein the secondinner portion and the second outer portion slope away from the arcuateslot in an opposed second direction.

Example 18

The cartridge of any of Examples 16 through 17, further comprising aplurality of stand-off members arranged on the deck and configured toengage tissue, wherein top surfaces of the stand-off memberscollectively define an upper plane, wherein the first outer portion andthe second outer portion of the deck are sloped relative to the upperplane.

Example 19

A surgical instrument comprising: (a) a body; (b) a shaft assemblyextending distally from the body; (c) an end effector at a distal end ofthe shaft assembly, wherein the end effector comprises: (i) a supportstructure, (ii) an anvil fixed relative to the support structure,wherein the anvil includes a plurality of staple-forming pockets, and(iii) a cartridge housing, wherein the cartridge housing is movablerelative to the support structure to clamp tissue against the anvil,wherein the cartridge housing comprises: (A) a curved body, (B) a deckdefined by the curved body, (C) a plurality of staple openings formed inthe deck, wherein the staple openings are configured to house aplurality of staples, (D) an arcuate slot formed in the deck, whereinthe arcuate slot is configured to slidably receive a cutting membertherethrough, and (E) a plurality of stand-off members arranged on thedeck along a length of the arcuate slot, wherein a side portion of thedeck is sloped away from the stand-off members.

Example 20

The surgical instrument of Example 19, wherein the side portion of thedeck is sloped away from the stand-off members in a direction transverseto the arcuate slot.

IV. Miscellaneous

It should be understood that any one or more of the teachings,expressions, embodiments, examples, etc. described herein may becombined with any one or more of the other teachings, expressions,embodiments, examples, etc. that are described herein. Theabove-described teachings, expressions, embodiments, examples, etc.should therefore not be viewed in isolation relative to each other.Various suitable ways in which the teachings herein may be combined willbe readily apparent to those of ordinary skill in the art in view of theteachings herein. Such modifications and variations are intended to beincluded within the scope of the claims.

It should be appreciated that any patent, publication, or otherdisclosure material, in whole or in part, that is said to beincorporated by reference herein is incorporated herein only to theextent that the incorporated material does not conflict with existingdefinitions, statements, or other disclosure material set forth in thisdisclosure. As such, and to the extent necessary, the disclosure asexplicitly set forth herein supersedes any conflicting materialincorporated herein by reference. Any material, or portion thereof, thatis said to be incorporated by reference herein, but which conflicts withexisting definitions, statements, or other disclosure material set forthherein will only be incorporated to the extent that no conflict arisesbetween that incorporated material and the existing disclosure material.

The surgical instrument systems described herein have been described inconnection with the deployment and deformation of staples; however, theembodiments described herein are not so limited. Various embodiments areenvisioned which deploy fasteners other than staples, such as clamps ortacks, for example. Moreover, various embodiments are envisioned whichutilize any suitable means for sealing tissue. For instance, an endeffector in accordance with various embodiments can comprise electrodesconfigured to heat and seal the tissue. Also, for instance, an endeffector in accordance with certain embodiments can apply vibrationalenergy to seal the tissue.

Versions of the devices described above may have application inconventional medical treatments and procedures conducted by a medicalprofessional, as well as application in robotic-assisted medicaltreatments and procedures. By way of example only, various teachingsherein may be readily incorporated into a robotic surgical system suchas the DAVINCI™ system by Intuitive Surgical, Inc., of Sunnyvale, Calif.Similarly, those of ordinary skill in the art will recognize thatvarious teachings herein may be readily combined with various teachingsof any of the following: U.S. Pat. No. 8,479,969, entitled “DriveInterface for Operably Coupling a Manipulatable Surgical Tool to aRobot,” issued Jul. 9, 2013; U.S. Pat. Pub. No. 8,800,838, entitled“Robotically-Controlled Cable-Based Surgical End Effectors,” issued Aug.12, 2014, the disclosure of which is incorporated by reference herein;and/or U.S. Pat. No. 8,573,465, entitled “Robotically-ControlledSurgical End Effector System with Rotary Actuated Closure Systems,”issued Nov. 5, 2013, the disclosure of which is incorporated byreference herein.

Versions of the devices described above may be designed to be disposedof after a single use, or they can be designed to be used multipletimes. Versions may, in either or both cases, be reconditioned for reuseafter at least one use. Reconditioning may include any combination ofthe steps of disassembly of the device, followed by cleaning orreplacement of particular pieces, and subsequent reassembly. Inparticular, some versions of the device may be disassembled, and anynumber of the particular pieces or parts of the device may beselectively replaced or removed in any combination. Upon cleaning and/orreplacement of particular parts, some versions of the device may bereassembled for subsequent use either at a reconditioning facility, orby an operator immediately prior to a procedure. Those skilled in theart will appreciate that reconditioning of a device may utilize avariety of techniques for disassembly, cleaning/replacement, andreassembly. Use of such techniques, and the resulting reconditioneddevice, are all within the scope of the present application.

By way of example only, versions described herein may be sterilizedbefore and/or after a procedure. In one sterilization technique, thedevice is placed in a closed and sealed container, such as a plastic orTYVEK bag. The container and device may then be placed in a field ofradiation that can penetrate the container, such as gamma radiation,x-rays, or high-energy electrons. The radiation may kill bacteria on thedevice and in the container. The sterilized device may then be stored inthe sterile container for later use. A device may also be sterilizedusing any other technique known in the art, including but not limited tobeta or gamma radiation, ethylene oxide, or steam.

Having shown and described various embodiments of the present invention,further adaptations of the methods and systems described herein may beaccomplished by appropriate modifications by one of ordinary skill inthe art without departing from the scope of the present invention.Several of such potential modifications have been mentioned, and otherswill be apparent to those skilled in the art. For instance, theexamples, embodiments, geometrics, materials, dimensions, ratios, steps,and the like discussed above are illustrative and are not required.Accordingly, the scope of the present invention should be considered interms of the following claims and is understood not to be limited to thedetails of structure and operation shown and described in thespecification and drawings.

We claim:
 1. A cartridge for use with a surgical instrument, thecartridge comprising: (a) a curved body; (b) a deck defined by thecurved body, wherein the deck includes an elongate side edge and isconfigured to clamp tissue against an anvil; (c) a plurality of stapleopenings formed in the deck, wherein the staple openings are configuredto house a plurality of staples; (d) a plurality of discrete stand-offmembers arranged on the deck and configured to engage tissue; and (e) anarcuate slot formed in the deck, wherein the arcuate slot is configuredto slidably receive a cutting member therethrough along a longitudinalaxis that extends distally, wherein the deck includes a sloped deckportion that slopes away at a constant angle from the arcuate slot tothe elongate side edge along either side of the entire length of thearcuate slot, wherein the sloped deck portion is configured to providevaried compression of tissue across a width of the deck, and wherein thediscrete stand-off members are disposed on the sloped deck portion andcollectively terminate distally at a plane orthogonal to thelongitudinal axis such that the discrete stand-off members vary inheight relative to the sloped deck portion, wherein the plurality ofdiscrete stand-off members includes an inner plurality of stand-offmembers and an outer plurality of stand-off members, wherein the outerplurality of stand-off members extends further away from the sloped deckportion than the inner plurality of stand-off members.
 2. The cartridgeof claim 1, wherein the sloped deck portion extends along a full lengthof the arcuate slot.
 3. The cartridge of claim 1, wherein at least someof the staple openings are arranged on the sloped deck portion.
 4. Thecartridge of claim 1, wherein the deck includes a first elongate sideedge and an opposed second elongate side edge, wherein the sloped deckportion comprises: (i) a first side portion of the deck that slopes awayfrom the arcuate slot in a direction toward the first elongate sideedge, and (ii) a second side portion of the deck that slopes away fromthe arcuate slot in a direction toward the second elongate side edge. 5.The cartridge of claim 1, wherein at least some of the discretestand-off members are arranged on the sloped deck portion.
 6. Thecartridge of claim 5, wherein top surfaces of the discrete stand-offmembers collectively define an upper plane, wherein the sloped deckportion is sloped relative to the upper plane.
 7. The cartridge of claim5, wherein the discrete stand-off members are laterally offset from thearcuate slot.
 8. The cartridge of claim 5, wherein each of the discretestand-off members wraps around at least a portion of an adjacent stapleopening of the plurality of staple openings.
 9. The cartridge of claim5, wherein at least some of the discrete stand-off members include afirst end feature that wraps at least partially around an end portion ofa first staple opening of the plurality of staple openings, and anopposed second end feature that wraps at least partially around an endportion of a second staple opening of the plurality of staple openings.10. The cartridge of claim 9, wherein the first end feature is connectedwith the second end feature by a recessed bridge portion.
 11. Thecartridge of claim 1, further comprising a pair of ridges extendingalong opposed sides of the arcuate slot.
 12. The cartridge of claim 1,further comprising a circular opening formed in the deck adjacent to anend of the arcuate slot, wherein the circular opening is configured toslidably receive a pin therethrough.
 13. The cartridge of claim 12,wherein the circular opening communicates with the arcuate slot.
 14. Thecartridge of claim 12, wherein at least one of the staple openingsextends beyond the circular opening in a direction toward acorresponding end of the deck.
 15. A cartridge for use with a surgicalinstrument, the cartridge comprising: (a) a curved body; (b) a deckdefined by the curved body, wherein the deck is configured to clamptissue against an anvil, wherein the deck includes a first elongate sideedge and an opposed second elongate side edge; (c) an arcuate slotformed in the deck, wherein the arcuate slot extends along the deck andbetween the first and second elongate side edges, wherein the arcuateslot is configured to slidably receive a cutting member therethrough;(d) a plurality of staple openings formed in the deck, wherein thestaple openings are configured to house a plurality of staples, whereina first row of the staple openings extends along the deck between thefirst elongate side edge and the arcuate slot and is immediatelyadjacent to a first side of the arcuate slot, wherein a second row ofthe staple openings extends along the deck between the second elongateside edge and the arcuate slot and is immediately adjacent to a secondside of the arcuate slot; and (e) a plurality of stand-off membersarranged on the deck and configured to engage tissue, wherein eachstand-off member includes a first end feature that wraps at leastpartially around an end portion of a first staple opening of theplurality of staple openings and a second end feature that wraps atleast partially around an end portion of a second staple opening of theplurality of staple openings, wherein the first end feature isintegrally connected with the second end feature at a location above thedeck, wherein a first outer portion of the deck extending between thefirst elongate side edge and the first row is recessed relative to atissue contacting portion of the arcuate slot, wherein a second outerportion of the deck extending between the second elongate side edge andthe second row is recessed relative to the tissue contacting portion ofthe arcuate slot, wherein a first inner portion of the deck extendingbetween the arcuate slot and the first row slopes away from the arcuateslot in a first direction.
 16. The cartridge of claim 15, wherein thedeck comprises a second inner portion extending between the arcuate slotand the second row, wherein the first outer portion slopes away from thearcuate slot in the first direction, wherein the second inner portionand the second outer portion slope away from the arcuate slot in anopposed second direction.
 17. The cartridge of claim 15, wherein topsurfaces of the stand-off members collectively define an upper plane,wherein the first outer portion and the second outer portion of the deckare sloped relative to the upper plane.